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Suction diathermy adenoidectomy performed in the district general hospital

Published online by Cambridge University Press:  14 January 2014

N Sethi ,
P Egan  and
V M M Ward
N Sethi*
Affiliation:
Department of Otolaryngology, Mid Yorkshire NHS Trust, Pinderfields Hospital, Wakefield, UK
P Egan
Affiliation:
Department of Precancer Genomics, Leeds Institute of Molecular Medicine, St James' University Hospital, UK
V M M Ward
Affiliation:
Department of Otolaryngology, Mid Yorkshire NHS Trust, Pinderfields Hospital, Wakefield, UK
*
Address for correspondence: Mr N Sethi, 3 Victoria St, Leeds LS7 4PA, UK E-mail: [email protected]
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Abstract

Background:

Adenoidectomy is often carried out in children for conditions such as nasal obstruction, otitis media with effusion, and obstructive sleep apnoea. Traditionally, it is performed as a blind procedure with a St Clair Thomson curette. An acceptable alternative technique is suction diathermy adenoidectomy. This study aimed to ensure that the complication rate of this latter technique was within published rates and national guidelines.

Method:

A retrospective case note review was conducted, and information regarding surgery, indications and complications was collected.

Results:

Post-operative haemorrhage was recorded for 2 of 121 patients (at days 10 and 11 post-operatively): 1 returned to the operating theatre and the other was managed conservatively. Two patients were diagnosed with infection post-operatively and managed with oral antibiotics. A further four patients re-presented with pain; in all cases, this was recorded as secondary to tonsillar fossa infection, rather than being pain related to adenoidectomy.

Conclusion:

Given the rare but serious potential complications, the authors support National Institute for Health and Clinical Excellence guidance, which recommends that only surgeons with specific training perform this technique. By using the standard procedures for clinical governance, it is possible to ensure safe practice of even little-used techniques.

Keywords

AdenoidectomyDiathermyComplications
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 1 , January 2014 , pp. 78 - 81
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Wright, ED, Manoukian, JJ, Shapiro, RS. Ablative adenoidectomy: a new technique using simultaneous liquefaction/aspiration. J Otolaryngol 1997;26:36–43Google Scholar
2National Institute for Health and Clinical Excellence. Suction Diathermy Adenoidectomy. Interventional Procedure Guidance 328. London: NICE, 2009Google Scholar
3Dhanasekar, G, Liapi, A, Turner, N. Adenoidectomy techniques: UK survey. J Laryngol Otol 2010;124:199–203CrossRefGoogle ScholarPubMed
4Lowe, D, van der Meulen, J, Cromwell, D, Lewsey, J, Copley, L, Browne, J et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope 2007;117:717–24Google Scholar
5Reed, J, Sridhara, S, Brietzke, SE. Electrocautery adenoidectomy outcomes: a meta-analysis. Otolaryngol Head Neck Surg 2009;140:148–53CrossRefGoogle ScholarPubMed
6Clemens, J, McMurray, JS, Willging, JP. Electrocautery versus curette adenoidectomy: comparison of postoperative results. Int J Pediatr Otorhinolaryngol 1998;43:115–22CrossRefGoogle ScholarPubMed
7Durr, DG. Endoscopic electrosurgical adenoidectomy: technique and outcomes. J Otolaryngol 2004;33:82–7Google Scholar
8Jonas, NE, Sayed, R, Prescott, CA. Prospective, randomized, single-blind, controlled study to compare two methods of performing adenoidectomy. Int J Pediatr Otorhinolaryngol 2007;71:1555–62CrossRefGoogle ScholarPubMed
9Skilbeck, CJ, Tweedie, DJ, Lloyd-Thomas, AR, Albert, DM. Suction diathermy for adenoidectomy: complications and risk of recurrence. Int J Pediatr Otorhinolaryngol 2007;71:917–20Google Scholar
10Walker, P. Pediatric adenoidectomy under vision using suction-diathermy ablation. Laryngoscope 2001;111:2173–7Google Scholar
11Wong, L, Moxham, JP, Ludemann, JP. Electrosurgical adenoid ablation. J Otolaryngol 2004;33:104–6Google Scholar
12Wynn, R, Rosenfeld, RM. Outcomes in suction coagulator adenoidectomy. Arch Otolaryngol Head Neck Surg 2003;129:182–5Google Scholar
13Lowe, D, Brown, P, Yung, M. Adenoidectomy technique in the United Kingdom and postoperative hemorrhage. Otolaryngol Head Neck Surg 2011;145:314–18Google Scholar
14Henry, LR, Gal, TJ, Mair, EA. Does increased electrocautery during adenoidectomy lead to neck pain? Otolaryngol Head Neck Surg 2005;133:556–61Google Scholar
15Baker, LL, Bower, CM, Glasier, CM. Atlanto-axial subluxation and cervical osteomyelitis: two unusual complications of adenoidectomy. Ann Otol Rhinol Laryngol 1996;105:295–9CrossRefGoogle ScholarPubMed
16Wormald, PJ, Prescott, CA. Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings. J Laryngol Otol 1992;106:342–4Google Scholar
17Simonsen, AR, Duncavage, JA, Becker, SS. A review of malpractice cases after tonsillectomy and adenoidectomy. Int J Pediatr Otorhinolaryngol 2010;74:977–9Google Scholar